Sulphasalazine in rheumatoid arthritis

Abstract

<h3>Objective</h3> The primary purpose of the current study was to investigate the clinical applicability of Brain Network Activation (BNA), a novel event-related-potential (ERP)-based brain imaging technology, to assess cognitive changes following scopolamine-induced impairment. <h3>Design</h3> In a double-blind, placebo-controlled, crossover study subjects received scopolamine to induce cognitive impairment. An auditory oddball task was performed while high density EEG data was recorded before, during and 1 week after impairment reversal. <h3>Settings</h3> Research center (CRO). Clinical care not applicable. <h3>Participants</h3> Healthy volunteers of both genders aged 18–45 years. Fifteen participants were enrolled, 13 completed the study. <h3>Interventions</h3> 0.4 mg of scopolamine was administered subcutaneously. <h3>Main Outcome Measurements</h3> Brain network activity of subjects was evaluated and quantified using the BNA technology. Significant change in BNA scores across visits for each subject was identified by a Minimal Important Difference (MID) measure. MID defines the range of normal variability between scores from two repeated visits, based on an external control database (N=75). Changes in BNA scores which cross the MID indicate a significant level of cognitive impairment. <h3>Results</h3> A significant decline (p&lt;0.01) in BNA scores was observed as a result of scopolamine induced impairment, followed by a significant recovery (p&lt;0.001). At recovery, scores returned to baseline (p=0.58). MID analysis showed that the effect of scopolamine was significantly larger than that of placebo in individual subjects (p&lt;0.05). <h3>Conclusions</h3> Pharmacologically induced cognitive impairment was successfully identified utilising the BNA technology. The technology could potentially be used clinically to provide functional information regarding network-based cognitive impairment associated with concussion.